Systems and methods for safe delivery of electrical stimulation therapy

Abstract

Systems and methods for treating arrhythmias are disclosed. In one embodiment an LCP comprises a housing, a plurality of electrodes for sensing electrical signals emanating from outside of the housing, an energy storage module disposed within the housing, and a control module disposed within the housing and operatively coupled to the plurality of electrodes. The control module may be configured to receive electrical signals via two or more of the plurality of electrodes and determine if the received electrical signals are indicative of a command for the LCP to deliver ATP therapy. If the received electrical signals are indicative of a command for the LCP to deliver ATP therapy, the control module may additionally determine whether a triggered ATP therapy mode of the LCP is enabled. If the triggered ATP therapy mode is enabled, the control module may cause the LCP to deliver ATP therapy via the plurality of electrodes.

What is claimed is: 
     
       1. A leadless cardiac pacemaker (LCP) comprising:
 a housing; 
 a plurality of electrodes for sensing electrical signals emanating from outside of the housing; 
 an energy storage module disposed within the housing; 
 a control module disposed within the housing and operatively coupled to the plurality of electrodes, wherein the control module is configured to:
 receive electrical signals via two or more of the plurality of electrodes; 
 determine whether the received electrical signals are indicative of a command for the LCP to deliver a pacing therapy that includes post-shock pacing therapy; 
 when the received electrical signals are indicative of a command for the LCP to deliver a pacing therapy that includes post-shock pacing therapy, determine whether a post-shock pacing therapy mode of the LCP is enabled;
 when the received electrical signals are indicative of a command for the LCP to deliver a pacing therapy that includes post-shock pacing therapy and the post-shock pacing therapy mode of the LCP is enabled, deliver post-shock pacing therapy via two or more of the plurality of electrodes; and 
 when the received electrical signals are indicative of a command for the LCP to deliver a pacing therapy that includes post-shock pacing therapy and the post-shock pacing therapy mode is not enabled, not delivering post-shock pacing therapy via two or more of the plurality of electrodes. 
 
 
 
     
     
       2. The LCP of  claim 1 , wherein the post-shock pacing therapy is enabled when the LCP is determined to be part of a medical system that includes a remote device that is configured to communicate the command to the LCP to deliver the pacing therapy that includes the post-shock pacing therapy. 
     
     
       3. The LCP of  claim 1 , wherein the pacing therapy that includes post-shock pacing therapy further includes an anti-tachyarrhythmia pacing (ATP) therapy that is delivered before the post-shock pacing therapy. 
     
     
       4. The LCP of  claim 3 , wherein the pacing therapy includes delivering the anti-tachyarrhythmia pacing (ATP) therapy only when an anti-tachyarrhythmia pacing (ATP) therapy mode of the LCP is enabled, and delivering the post-shock pacing therapy only when the post-shock pacing therapy mode of the LCP is enabled. 
     
     
       5. The LCP of  claim 3 , wherein:
 the pacing therapy includes delivering the anti-tachyarrhythmia pacing (ATP) therapy only when an anti-tachyarrhythmia pacing (ATP) therapy mode of the LCP is enabled; and 
 delivering the post-shock pacing therapy only when:
 the post-shock pacing therapy mode of the LCP is enabled; and 
 only when the anti-tachyarrhythmia pacing (ATP) therapy was ineffective at terminating a detected tachyarrhythmia. 
 
 
     
     
       6. The LCP of  claim 3 , when the received electrical signals are indicative of a command for the LCP to deliver a pacing therapy that includes the post-shock pacing therapy and an anti-tachyarrhythmia pacing (ATP) therapy, the control module further configured to: determine whether an ATP therapy mode of the LCP is enabled;
 when the received electrical signals are indicative of a command for the LCP to deliver the pacing therapy that includes the post-shock pacing therapy and the anti-tachyarrhythmia pacing (ATP) therapy, and the ATP therapy mode is enabled, deliver the ATP therapy via two or more of the plurality of electrodes; and 
 when the received electrical signals are indicative of a command for the LCP to deliver the pacing therapy that includes the post-shock pacing therapy and the anti-tachyarrhythmia pacing (ATP) therapy, and the ATP therapy mode is not enabled, not delivering the ATP therapy via two or more of the plurality of electrodes. 
 
     
     
       7. The LCP of  claim 6 , wherein the control module of the LCP is further configured to determine whether to deliver ATP therapy before delivering the ATP therapy, based at least in part on whether a heart rate, determined from the received electrical signals, is above an arrhythmia threshold. 
     
     
       8. The LCP of  claim 1 , wherein the post-shock pacing therapy includes delivering post-shock pacing pulses via two or more of the plurality of electrodes. 
     
     
       9. The LCP of  claim 8 , wherein the post-shock pacing pulses have an larger amplitude relative to pacing pulses delivered during normal bradycardia pacing therapy, and are only delivered for a limited period of time once initiated. 
     
     
       10. A leadless cardiac pacemaker (LCP) comprising:
 a housing; 
 a plurality of electrodes for sensing electrical signals emanating from outside of the housing; 
 an energy storage module disposed within the housing; 
 a control module disposed within the housing and operatively coupled to the plurality of electrodes, wherein the control module is configured to:
 receive electrical signals via two or more of the plurality of electrodes; 
 determine whether the received electrical signals include a signal for the initiation of a post-shock pacing therapy; 
 when the received electrical signals include the signal for the LCP to initiate delivery of the post-shock pacing therapy, determine whether a post-shock pacing therapy mode of the LCP is enabled;
 when the received electrical signals include the signal for the LCP to initiate delivery of the post-shock pacing therapy and the post-shock pacing therapy mode of the LCP is enabled, deliver the post-shock pacing therapy via two or more of the plurality of electrodes; and 
 when the received electrical signals include the signal for the LCP to initiate delivery of the post-shock pacing therapy and the post-shock pacing therapy mode is not enabled, not delivering the post-shock pacing therapy via two or more of the plurality of electrodes. 
 
 
 
     
     
       11. The LCP of  claim 10 , wherein the signal for delivery of the post-shock pacing therapy comprises a trigger signal from a remote implantable medical device. 
     
     
       12. The LCP of  claim 10 , wherein the signal for delivery of the post-shock pacing therapy comprises a command from a remote implantable medical device. 
     
     
       13. The LCP of  claim 10 , wherein the post-shock pacing therapy includes delivering post-shock pacing pulses that have a larger amplitude relative to pacing pulses delivered during normal bradycardia pacing therapy. 
     
     
       14. The LCP of  claim 13 , wherein the post-shock pacing pulses are only delivered for a limited period of time. 
     
     
       15. A leadless cardiac pacemaker (LCP) comprising:
 a housing; 
 a plurality of electrodes for sensing electrical signals emanating from outside of the housing; 
 an energy storage module disposed within the housing; 
 a control module disposed within the housing and operatively coupled to the plurality of electrodes, wherein the control module is configured to:
 receive electrical signals via two or more of the plurality of electrodes; 
 determine whether the received electrical signals include a signal for the initiation of a predetermined pacing therapy type; 
 determine whether the predetermined pacing therapy type of the LCP is enabled;
 when the received electrical signals include the signal for the LCP to deliver the predetermined pacing therapy type and the predetermined pacing therapy type is enabled, deliver the predetermined pacing therapy type via two or more of the plurality of electrodes; and 
 when the received electrical signals include the signal for the LCP to deliver the predetermined pacing therapy type and the predetermined pacing therapy type is not enabled, not delivering the predetermined pacing therapy type via two or more of the plurality of electrodes. 
 
 
 
     
     
       16. The LCP of  claim 15 , wherein the predetermined pacing therapy type comprises post-shock pacing therapy. 
     
     
       17. The LCP of  claim 15 , wherein the predetermined pacing therapy type comprises anti-tachyarrhythmia pacing (ATP) therapy. 
     
     
       18. The LCP of  claim 17 , wherein the control module is further configured to:
 determine whether the received electrical signals include a signal for the initiation of a post-shock pacing therapy; 
 determine whether post-shock pacing therapy of the LCP is enabled;
 when the received electrical signals include the signal for the LCP to initiate delivery of the post-shock pacing therapy and the post-shock pacing therapy is enabled, deliver the post-shock pacing therapy via two or more of the plurality of electrodes; and 
 when the received electrical signals include the signal for the LCP to initiate delivery of the post-shock pacing therapy and the post-shock pacing therapy is not enabled, not delivering the post-shock pacing therapy via two or more of the plurality of electrodes. 
 
 
     
     
       19. The LCP of  claim 17 , wherein the predetermined pacing therapy type comprises an anti-tachyarrhythmia pacing (ATP) therapy followed by a post-shock pacing therapy when the anti-tachyarrhythmia pacing (ATP) therapy is not successful. 
     
     
       20. The LCP of  claim 19 , wherein the signal for the initiation of the predetermined pacing therapy type comprises a trigger signal from a remote implantable medical device.